Both in my Comments section and in the comments on other blogs, cyberpals and strangers have been telling me that Dr. Larry McCleary’s book, The Brain Trust, recommends a ketogenic diet for migraine. I have had it on hold at the library, and I finally finished it last week.
If you read my blog because you are a migraine sufferer, please read this book. If you read this blog because you are a devoted low-carber, you will find yet more confirmation of the health benefits of the low-carb lifestyle for everyone, not just people who need help managing their weight. And if you read the blog because you are interested in low-carb, but wary, or if you stumbled onto this entry because you googled “Alzheimer’s” or “Parkinson’s,” please also read this book.
I’d particularly like to address myself to my migraine friends, but before I do, let me make some general comments. If you are a long-time fan of low-carb, you know that skipping the bread, pasta, rice, potatoes, and dessert leads to weight loss, stable blood sugar, improved lipids, and rapidly normalized blood pressure. If you are like me, you also suspect that you’re doing good things for the rest of your body - your joints may have stopped aching, your acid reflux may have improved, your acne may have cleared up, your PMS may be less severe - heck, I am convinced that low-carb is responsible for the near disappearance of my carpal tunnel. (Actually, what I’m convinced of is that it wasn’t carpal tunnel at all, but hyperglycemia-related neuropathy.) And, of course, you may have noticed that your mood has improved and your after-lunch brain fog has disappeared. Again, if you’re like me, you may know some people who, although not overweight, might benefit from skipping their daily Coke to clear up some nagging health problems, but have the false perception that low-carb is just for weight loss. If so, please ask them to read this book - McCleary’s recommended diet to prevent the gradual cognitive decline that so many of us think is inevitable looks very much like the maintenance phases of the Atkins and Protein Power diets.
And now, for my migraine friends: if you don’t want to read the whole book, please at least read the chapter on migraine. I know that migraine is a complex disease, or series of diseases, and after a year spent combing the interwebs for every scrap of information I could find, I know that what works for some people fails miserably for others. I also know that there are many lifelong migraine sufferers who have tried everything from pharmaceuticals to biofeedback to elimination diets to Chinese herbal medicine. And I also know my blog is heavily biased in favor of low-carb, because low-carb has bestowed so many general health benefits on me. Having said all that, the reason I am so excited about McCleary’s migraine prevention plan is that I have never seen anyone explicitly recommend a ketogenic diet for migraine before. So, if you feel you’ve tried everything, this kind of intervention may be news to you. And while a ketogenic diet can be somewhat more expensive than the standard American grain-based diet, it is less expensive than pharmaceuticals, and it is certainly less expensive than alternative therapies that are not covered by your health insurance. Finally, it seems like a relatively safe treatment to try. And as I wrote several weeks ago, there are some reasons to think that it might make sense. For one thing, McCleary stresses that periods of low-blood sugar can cause migraines, and that rings true to me because many people, me included, find that skipping meals, especially breakfast, can trigger migraine. (In fact, skipping meals and losing sleep are the only two things that reliably triggered migraines for me, pre-Inderal.) McCleary’s argument is that a ketogenic diet bypasses the blood sugar cycle altogether by offering the brain ketones as an alternative fuel source.
One note: one of McCleary’s recommendations for migraineurs is an MCT (medium-chain triglyceride) supplement. This seems unnecessarily expensive to me. Coconut oil is about 60% medium-chain fatty acids, is cheaper, and can be used in cooking and baking. So you could replace a couple of tablespoons of other fats in your diet with coconut oil, and probably get the same benefit.
The book does have its shortcomings. It’s not a lengthy volume, and several pages in the center of the book are occupied with little exercises you can do to test and improve your cognitive abilities, which makes the book even shorter than it appears. I sometimes feel that, because of the brevity of the book, McCleary sacrifices details that could help make his case. When discussing the use of ketogenic diet, he does not describe in great detail exactly how one does such a diet (check out Dr. Atkins’ New Diet Revolution or Protein Power if you need details), and he doesn’t address the health concerns that many people in today’s fat phobic world will have. Furthermore, he doesn’t say whether the ketogenic diet should be adhered to indefinitely, or whether one should stick to it for several weeks and then go back to his ordinary recommended diet. And for those of us who are low-carb fans and know the almost magical weight-loss effects of ketosis, it would be nice if he gave some guidance on how exactly a normal weight person avoids weight loss on a ketogenic diet.
Disclosure: Perigee Trade, the publisher of The Brain Trust, is owned by the same company that owns the company where I work. Please note, however, that even if every single one of my 100 or so daily readers bought a copy of that book, and persuaded two other people to buy it, too, the total effect on the value of my company’s stock would be nil. Seriously.
Migraine aura picture from 
